HESI MEDICAL SURGICAL EXAM WITH DETAILED SOLUTIONS
A client receives a new prescription for pentazocine (Talwin), a mixed opioid
agonist-antagonist, after an opioid agonist is discontinued. What is the
advantage for the client when the new prescription is implemented?
Rationale
Mixed agonist-antagonists bind as an agonist at the Kappa receptor and as
antagonists or partial agonists on the mu receptor, which produces less
respiratory depression than opioid agonists that are pure mu agonists.
A client who has Trichomonas vaginalis receives a prescription for metronidazole
(Flagyl). Which instruction should the nurse provide during client education? Do
not ingest with diary products.
Notify the clinic if the urine changes color.
Obtain liver function tests every 3 months.
Avoid over-the-counter antitussives.
Rationale
Flagyl can produce a disulfiram (Antabuse)-like reaction when combined with
products containing alcohol, such as over-the-counter cough remedies, so the
client should be informed to avoid ingesting any alcohol product during the use
of Flagyl.
A client receives a new prescription for an angiotensin-converting enzyme (ACE)
inhibitor. What client history contraindicates its use? Asthma.
Heart failure.
Renal artery stenosis.
Coronary artery disease.
Rationale
Angiotensin-converting enzyme (ACE) inhibitors can cause severe renal
insufficiency in clients with bilateral renal artery stenosis or stenosis in the artery
to a single remaining kidney.
Which side effects should the nurse monitor for a client who is receiving
dexamethasone (Decadron) following neurosurgery? (Select all that apply.)
Select all that apply
Some correct answers were not selected
Mood swings.
Tolerance does not occur.
Less agitation is experienced.
The analgesic ceiling is higher.
Respiratory depression is less.
Decreased appetite.
Increased weight gain.
Serum glucose level of 65 mg/dl.
Delayed incisional wound healing.
Serum hemoglobin level of 9 mg/dl.
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